Maybe I am denser than usual today... Is there anything that prevents a payer or a provider from implementing the "unsolicited 277" transaction today? I know the implementation guide is not very "fresh", but it is available in the wpc-edi web site.
Or, are payers waiting to be mandated by the government to implement this transaction? Ditto for the 271 roster, or for the upcoming 824. Kepa Christopher J. Feahr, OD wrote: > The inability of a payor to use the 277 to send an un-solicited LIST of > pended claims does seem like a technicality that could be fixed... if > there was a really need to do that. The more likely scenario, however, > is that a provider wants to ask "what the heck's going on with" a list > of UNPAID claims. If the 276 doesn't allow him to ask for status on a > "list" then he could alternatively send a whole bunch of separate 276s. > > Medicaid does seem to be the only payor who periodically sends me > unsolicited lists of "pended" claims... and as a provider I find this > generally unhelpful, and in some cases highly annoying. The process of > filing a Medicaid claim is frequently automated and can be done > electronically. "Resubmission Turnaround Documents" and "Claim Inquiry > Forms", however, are generally not automated and would have to be filled > out manually (paper) and mailed. Consequently, many providers who get > an "RTD" in the mail or see a denial (due to an accidental submission > error) on an EOB, find it more expedient to simply resubmit the claim > with the corrected information. Long after the second (resubmitted) > claim is settled, the provider continues to get these unsolicited > notifications that the original claim is still going through this slow > death process involving various stages of "suspension". The provider > soon learns to ignore all/most unsolicited status status advice like this. > > I would say that if the provider isn't yelling at a payor about a pended > claim, it means that he DOESN'T WANT any status information about it. > (or it means that he's asleep, in which case he doesn't deserve any > status information and would probably be confused by it if the payor > sent it out of the blue!) > > Regards, > Chris > > At 04:42 PM 2/22/02 -0500, Young, Brian wrote: > >> Maria, >> >> If I understand what you are indicating... If a provider >> sends a 276 claim status request and that claim is pended, >> the 277 does not cover that pended status response >> possibility so no response can be sent. Nor can a payer >> send a 277 (unsolicited) back with a 835 containing any >> pended claims. >> >> And the reason is because "Pended" claim status is not a >> HIPAA transaction. Am I understanding you correctly? >> >> If so this would seem like splitting hairs. For certainly >> the 277 does cover claim status reporting. >> >> >> BCY >> >> Brian C. Young >> Senior Software Engineer >> Accu-Med Services >> An OmniCare Company >> 300 TechneCenter Dr. >> Milford, OH 45150 >> >> >> ********************************************************************** >> To be removed from this list, send a message to: >> [EMAIL PROTECTED] >> Please note that it may take up to 72 hours to process your request. > > > Christopher J. Feahr, OD > http://visiondatastandard.org > [EMAIL PROTECTED] > Cell/Pager: 707-529-2268 > > > ********************************************************************** > To be removed from this list, send a message to: > [EMAIL PROTECTED] > Please note that it may take up to 72 hours to process your request. ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request.
